Ductography: Role in Pathological Nipple Discharge

Abstract

ABSTRACT: Ductography (DG) or Glactography is investigation of choice for evaluation of unilateral, single duct, spontaneous nipple discharge regardless of its appearance. It is an invasive procedure needs cannulation of the lactiferous duct for injection of the contrast for diagnosis of the abnormality. Since pathological nipple discharge may be caused by benign pathology, such as fibrocystic disease, ductal ectasia, papillomas, or by carcinoma. Identification of intraductal abnormalities with DG is important. It helps in providing the accurate diagnosis, the location and depth of the lesion. When ductal ectasia or fibrocystic changes are causing the discharge, conservative follow-up is considered. DG can be diagnostic or preoperative for localization to guide accurate surgical intervention. DG of the breast is an underused procedure because cannulation of the duct orifice is a source of great stress as the opening of duct is very small and some time it is difficult to cannulate the duct. There are 17-20 ducts opening on the surface of nipple the one with pathology can only be identified when discharge is seen during the procedure. The procedure is easy to perform if the performing radiologist has learned the basic principles of DG and has proper equipment and patience. Keywords: Ductography, glactography, nipple discharge, mammography, MR ductography, Mammary ductoscopy, Cytology, Ultrasound breast.